Integration of ICU data into electronic medical records-issues and solutions

The Intensive Care Unit (ICU) is the arena in which many succeed and many others perish in the intense battle between life and death. The systematic documentation of all events here will be invaluable for research purposes. Traditionally these are written on case sheets and maintained in paper form in the Medical Records Department. The advent of Electronic Medical Records (EMR) has not only changed the format of medical records but also increased accessibility of information contained in the repository, especially for research purposes. Unfortunately, in most implementations of Hospital Information Management System, many major pieces of information from the ICU fail to find a place in the EMR. Even in cases where the EMR has the fields corresponding to important information like exact time of delivery of medicines and food, notes by duty nurse, etc., these information are either not entered or incorrectly entered. ICU is characterized by periods of heavy load of urgent tasks to be finished within precious time and manual entry of information into the medical record will be either postponed or dropped. This creates a statistical skew in the information captured that will affect the analysis based on them. On the other hand, an ICU automation system can alleviate the severity of above problem to a large extent, since it can ubiquitously capture all important information from the ICU and store it in the EMR. We are currently implementing a Tablet PC based system for automation of the workflows in an ICU. This paper presents the working of the system in capturing the pertinent information so that it may be stored in the EMR. The issue of integration of the ICU management system with the rest of the HIMS is also briefly discussed.